AmarilloMD Patient Screening
Thank you for your interest in becoming our patient. Our process for onboarding new patients involves you filling out a screening questionnaire to be sure we are a good fit for your needs.
We are based on a monthly membership model. We don't bill insurance of any kind, but if you have insurance, it can be used for labs, imaging, and specialist visits if needed. If you are enrolling a child, an adult must also register. When you become an active patient, there will be a $75 initiation fee that will hold your membership. ($150 for families/couples).
Additional labs, in-office testing, and supplies are billed at affordable wholesale prices.
You may also check out our Facebook page for more information.
Here is a link to frequently asked questions:
Here is a link to an interview with Dr. Moore discussing direct primary care. Check it out!
Please feel free to call, text, or email your questions.
Administrator, Medical Assistant | AmarilloMD
Please answer the questions below to help us decide if this is the best fit for your needs.
First and Last Name
Date of Birth
1. How did you hear about us?
2. Why do you want to join our practice?
3. What are your main medical needs?
4. How many family members do you plan on having under your membership?
Me + 1
Me + 3
Me + 4
Me + 5
Not sure yet
5. Are you confident that our monthly membership fee fits within your current budget? There is a one-time non-refundable initiation fee of $75 or $150 for families/couples when you become a patient. The monthly membership fee for ages are above.
6. Are you currently employed? If not, who will be paying for your services with us?
7. I have watched the video of Dr. Moore speaking on direct primary care.
8. What questions do you have for us?
Please contact us if you have any further questions!
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Amarillo MD PLLC.